基于数据挖掘的国医大师刘祖贻治疗类风湿关节炎用药规律研究

Medication Rule in the Treatment of Rheumatoid Arthritis by National Chinese Medicine Master Liu Zuyi: An Analysis Using Data Mining

目的应用中医传承辅助系统软件,分析国医大师刘祖贻治疗类风湿关节炎的用药规律。方法收集、整理国医大师刘祖贻自2015年7月至2018年8月期间在湖南省中医药研究院附属医院接诊类风湿关节炎患者的病案,共计137例,将患者初诊处方录入中医传承辅助系统(V2.5),采用关联规则、聚类分析等数据挖掘方法,分析国医大师刘祖贻治疗类风湿关节炎用药规律。结果对筛选出的137首处方、141味中药进行分析,高频使用药物有青风藤、忍冬藤、防己、络石藤、生地黄;常用组合主要有青风藤-忍冬藤,青风藤-防己,青风藤-络石藤-忍冬藤等;挖掘出由忍冬藤、鸡血藤、络石藤、淫羊藿、黄芪、青风藤等组成的5首新处方。结论国医大师刘祖贻治疗类风湿关节炎用药特点鲜明,善用通络三类,分别是藤类通络药、虫类通络药、枝类通络药,且将寒凉药和温热药并用。

Objective To analyze the medication rule in treating rheumatoid arthritis(RA)by National Chinese Medicine Master Liu Zuyi using Traditional Chinese Medicine Inheritance Support System(TCMISS).Methods The clinical data of 137 RA patients who were treated by Master Liu in The Affiliated Hospital of Hunan Academy of Chinese Medicine from July 2015 to August 2018 were collected and sorted.The prescriptions following initial diagnosis were entered into TCMISS(V2.5),and then the data mining methods such as association rules and cluster analysis in the software were used to analyze the medication rule in the treatment of RA by Master Liu.Results The most commonly used medicines among 141 herbs involved in 137 prescriptions included Sinomenium acutum,Caulis Lonicerae,Stephania tetrandra,Caulis Trachelospermi,and Radix Rehmanniae.The commonly used combinations of medicines were Sinomenium acutum-Caulis Lonicerae,Sinomenium acutum-Stephania tetrandra,and Sinomenium acutum-Caulis Trachelospermi-Caulis Lonicerae.And five new prescriptions for treating RA were identified and consisted of Caulis Lonicerae,Caulis Spatholobi,Caulis Trachelospermi,Herba Epimedii,Astragalus membranaceus,Sinomenium acutum,etc.Conclusion Master Liu has rich experience and distinctive characteristics of medication in treating RA.He is good at using rattan-,insect-,and branch-type collateral-dredging Chinese medicines and combing warm medicines and cold medicines.